(WKBN) – The Pennsylvania Department of Health released updated guidance for nursing home facilities on Thursday, including COVID-19 testing strategies for facilities not experiencing an outbreak.
“We continue to practice a careful, measured approach in nursing homes so all staff and residents can safely welcome Compassionate Caregivers, in addition to visitors, and return to a more normal routine,” Secretary of Health Dr. Levine said. “Our updates on testing and compassionate caregiving follow the recommendations from the Centers for Medicare and Medicaid Services. We developed this guidance through collective input from stakeholders, interagency partners, industry leaders and facility representatives to allow safe caregiving, in addition to visitations with strong public health measures to balance the mental and physical well-being of Pennsylvania’s most vulnerable residents.”
Immediate testing of residents and staff with COVID-19 symptoms is highly recommended.
If a facility is not experiencing an outbreak, the Centers for Medicare and Medicaid Services and the health department recommend that they still test asymptomatic staff and some residents.
Here are the new testing recommendations:
- In a county with low COVID-19 activity, defined as less than 5 percent positivity rate within seven days according to federal data:
- Routine testing of asymptomatic residents is not recommended.
- Routine testing of asymptomatic staff is recommended every four weeks.
- In a county with moderate COVID-19 activity, defined as a seven day percent positivity between 5 and 10 percent according to federal data:
- Routine testing of asymptomatic residents is encouraged of all residents with outside contact in the last 14 days, if they have not otherwise been tested during that period.
- Routine testing of asymptomatic staff is recommended once a week.
- In a county with substantial COVID-19 activity, defined as a percent positivity greater than 10 percent according to federal data:
- Weekly testing is recommended of all asymptomatic residents with outside contact in the last 14-days, if they have not been otherwise tested during the period.
- Routine testing of all asymptomatic staff twice a week.
When facilities do have an outbreak, they are urged to start universal testing of all staff and residents.
“Compassionate caregiving” is permitted in limited situations. Facilities are expected to work with residents, family and staff to identify “compassionate caregivers” and let residents get the care they need to improve mental health.
A “compassionate caregiver” is a family member, friend, volunteer or other identified person who provides the resident with compassionate care.
Guidelines for “compassionate caregivers” can be found here.
Levine also talked about visitation at nursing home facilities.
Nursing home facilities must meet several prerequisites in order to proceed with the three-step reopening process.
First, the facility has to come up with an implementation plan, including the following minimum components:
- A comprehensive testing plan that includes information on when universal testing was completed, and the capacity and procedures to perform additional testing.
- A plan for cohorting or isolating residents diagnosed with COVID-19 in accordance with PA-HAN 509;
- Written screening protocols for all staff during each shift, each resident daily, and all persons entering the facility;
- A plan to ensure adequate staffing and supply of personal protective equipment for all staff;
- A plan to allow for communal dining and activities to resume; and
- A plan to allow for visitation.
The facility can then start the three-step reopening process:
Step One: From the date the facility enters step one, a facility must maintain no new COVID-19 outbreaks among staff or residents for 14 consecutive days in order to enter step two.
Step Two: While in step two, facilities are required to maintain no new outbreaks of COVID-19 among staff or residents for 14 consecutive days to progress into the final step.
Step three: The final step allows nursing homes to operate as outlined for the remainder of the Governor’s COVID-19 Disaster Declaration as long as there are no new COVID-19 outbreaks among staff and residents for 14 consecutive days.
Each step of the plan includes specific criteria for conducting dining, activities, non-essential personnel, volunteers, visitors and outings.
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